Abstract：
OBJECTIVE: To determine the safety and efficacy associated with drainage volumes greater than 1,500 mL in a single, unilateral thoracentesis without pleural manometry measurements.
METHODS: This retrospective, single-institution study included 872 patients (18 years and older) who underwent ultrasound-guided thoracentesis. Patient and procedures data were collected including demographics, number of and laterality of thoracenteses, volume and consistency of fluid removed, and whether clinical or radiologic evidence of re-expansion pulmonary edema (REPE) developed within 24 h of thoracentesis. Fisher\'s exact test was used to test the significance of the relationship between volume of fluid removed and evidence of REPE.
RESULTS: A total of 1376 thoracenteses were performed among the patients included in the study. The mean volume of fluid removed among all procedures was 901.1 mL (SD = 641.7 mL), with 194 (14.1%) procedures involving the removal of ≥ 1,500 mL of fluid. In total, six (0.7%) patients developed signs of REPE following thoracentesis, five of which were a first-time thoracentesis. No statistically significant difference in incidence of REPE was observed between those with ≥ 1,500 mL of fluid removed compared to those with < 1,500 mL of fluid removed (p-value = 0.599).
CONCLUSIONS: Large-volume thoracentesis may safely improve patients\' symptoms while preventing the need for repeat procedures.
METHODS: This retrospective, single-institution study included 872 patients (18 years and older) who underwent ultrasound-guided thoracentesis. Patient and procedures data were collected including demographics, number of and laterality of thoracenteses, volume and consistency of fluid removed, and whether clinical or radiologic evidence of re-expansion pulmonary edema (REPE) developed within 24 h of thoracentesis. Fisher\'s exact test was used to test the significance of the relationship between volume of fluid removed and evidence of REPE.
RESULTS: A total of 1376 thoracenteses were performed among the patients included in the study. The mean volume of fluid removed among all procedures was 901.1 mL (SD = 641.7 mL), with 194 (14.1%) procedures involving the removal of ≥ 1,500 mL of fluid. In total, six (0.7%) patients developed signs of REPE following thoracentesis, five of which were a first-time thoracentesis. No statistically significant difference in incidence of REPE was observed between those with ≥ 1,500 mL of fluid removed compared to those with < 1,500 mL of fluid removed (p-value = 0.599).
CONCLUSIONS: Large-volume thoracentesis may safely improve patients\' symptoms while preventing the need for repeat procedures.
摘要：
目的：为了确定单次引流量大于1,500mL的安全性和有效性，单侧胸腔穿刺术无胸膜测压测量。
方法：本回顾性研究，单机构研究纳入了接受超声引导下胸腔穿刺术的872例患者(18岁及以上).收集患者和手术数据，包括人口统计学，胸腔的数量和侧向性，去除的流体的体积和稠度，以及是否在胸腔穿刺术24小时内出现了再扩张性肺水肿（REPE）的临床或放射学证据。Fisher精确检验用于检验排出的液体体积与REPE证据之间的关系的显著性。
结果：在纳入研究的患者中，共进行了1376次胸腔镜手术。所有手术中排出的液体平均体积为901.1mL（SD=641.7mL），194例(14.1%)程序涉及去除≥1,500毫升液体。总的来说,6例（0.7%）患者在胸腔穿刺术后出现REPE征象，其中五次是首次胸腔穿刺术.在去除≥1,500mL液体的患者与去除<1,500mL液体的患者之间，REPE的发生率没有统计学上的显着差异（p值=0.599）。
结论：大容量胸腔穿刺术可以安全地改善患者的症状，同时防止重复手术的需要。
方法：本回顾性研究，单机构研究纳入了接受超声引导下胸腔穿刺术的872例患者(18岁及以上).收集患者和手术数据，包括人口统计学，胸腔的数量和侧向性，去除的流体的体积和稠度，以及是否在胸腔穿刺术24小时内出现了再扩张性肺水肿（REPE）的临床或放射学证据。Fisher精确检验用于检验排出的液体体积与REPE证据之间的关系的显著性。
结果：在纳入研究的患者中，共进行了1376次胸腔镜手术。所有手术中排出的液体平均体积为901.1mL（SD=641.7mL），194例(14.1%)程序涉及去除≥1,500毫升液体。总的来说,6例（0.7%）患者在胸腔穿刺术后出现REPE征象，其中五次是首次胸腔穿刺术.在去除≥1,500mL液体的患者与去除<1,500mL液体的患者之间，REPE的发生率没有统计学上的显着差异（p值=0.599）。
结论：大容量胸腔穿刺术可以安全地改善患者的症状，同时防止重复手术的需要。
